Most foodborne illnesses reported to health departments originate from food service establishments. The District of Columbia Department of Health conducts periodic inspections to assess the risk of foodborne illness. The occurrence trends of priority violations and their relationships to foodborne illness and resident complaints have not yet been investigated in the District of Columbia. This research studied the relationship between foodborne illness complaints reported by patrons and observed priority violations in food establishments. This study used a nonexperimental quantitative methodology that relied on preexisting data, including food establishment inspection reports and health statistics. The results showed that observed priority violations in food establishment inspections in the District of Columbia were positively correlated with two Centers for Disease Control and Prevention-identified foodborne illness risk factors: poor personal hygiene and contaminated equipment. The study results showed that patron-generated foodborne illness complaints were significantly correlated with improper holding temperatures and contaminated equipment. This study can act as a motivator to reevaluate existing food safety inspection enforcement practices and thereby reduce foodborne illnesses in the District of Columbia.